Steps for Safe Homes : Register

Joining Team SuzisSensationalSurvivors

First Name *

Last Name *

Email Address *

Password*

Mobile *

Shirt Size

We’ll reward your fundraising efforts with great prizes along the way.

(enter manually)

Address Line 1 *

Address Line 2

Town/Suburb *

Postcode *

State *

Country *

Would you like to receive merchandise rewards? eg. t-shirts, water bottles etc. *

Yes, I want to be rewarded for my fundraising!
No thanks, I have enough stuff. I don't want a shirt or anything else.

Did you do Steps For Safe Homes last year? *

Sure did!
Nope, this is my first time!

What is your primary motivation for signing up?